The Use of Rosiglitazone to Treat Asthma

Phase 2

Completed

Brief Summary: Asthma is a common chronic disease characterized by airway inflammation and bronchoconstriction. This study utilizes the drug rosiglitazone (Avandia)to treat the effects of airway inflammation in patients with asthma.

The study will be conducted on 14 adult steroid naive patients with asthma. Patients with qualifying pulmonary function testing values will be eligible for enrollment. Enrolled subjects will be treated with rosiglitazone orally at 2mg dose for 4 weeks. Patients will be reassessed and dosing will increase in 4 week increments up to 8mg.

Detailed Description: The current standard-of-care utilizes corticosteroids to down-regulate the inflammatory state in patients with asthma. However, corticosteroids have many side effects and are not universally effective. New safe anti-inflammatory agents are needed to help modulate the disease. Peroxisome proliferator-activated receptor agonists are widely used to manage diabetes mellitus, another common chronic disease. These agents have been study models and have been shown to have anti-inflammatory effects in lung tissue. Case reports have noted improvement in asthma symptoms in patients being treated with these agents. These agents are ideally placed for human research given their long record of safe use in the treatment of type 2 diabetes.

Recruitment & Eligibility

Inclusion Criteria

Able to comprehend and grant a witnessed, written informed consent
Must be greater than 19 years old
Must be able to swallow a tablet
Female participants must have a negative urine pregnancy test at visit 1 and throughout duration of the study
Must have a history of physician diagnosed asthma
Must have a baseline FEV1 >60% predicted
Must be able to perform pulmonary function testing
Must have methacholine-induced decrease in FEV1 of 20%
Must be capable of withholding medications that may affect the methacholine challenge test
Must be able to withstand a 30 day washout period for all inhaled corticosteroids
Must be able to attend all office visits, 4 weeks apart for 12 weeks. Each visit will last approximately 2-3 hours

Exclusion Criteria

Age 18 or younger
FEV1 <60% predicted value
History or presence of significant renal, hepatic,neurologic, cardiovascular, hematologic, cerebrovascular, respiratory, endocrine, gastrointestinal, or collagen vascular disorder that in the Investigator's opinion could interfere with the study or require medical attention that would interfere with the study.
History of cancer other than basal cell skin cancer
History of hypoglycemia
Current smokers, greater than 10 pack year history, or patients quitting less than 1 year prior to screening
History within the past year of excessive alcohol intake or drug addiction
History of respiratory infection requiring treatment with an antibiotic within 2 week prior to visit 1
Chronic intermittent use of inhaled, oral, intra-muscular, topical or intravenous corticosteroids within 4 weeks of visit 1
Inability to perform consistent spirometry or nitric oxide exhalation
Treatment with an experimental, non-approved drug, or investigational drug within the past 30 days
Known hypersensitivity to rosiglitazone
History of noncompliance to medical regimens and participants who are considered to be potentially unreliable

Arm && Interventions

Group	Intervention	Description
1	rosiglitazone	Subjects took rosiglitazone 2 mg for 4 weeks, then 4mg for 4 weeks, then 8 mg for 4 weeks

Primary Outcome Measures

Name	Time	Method
Methacholine Responsiveness as Assessed by PC20,	patients were assessed at baseline and at 12 weeks	PC20 is the concentration of methacholine at which patients had a decrease in Forced Expiratory Volume in one second (FEV1) of 20%

Secondary Outcome Measures

Name	Time	Method
Exhaled Nitric Oxide in Parts Per Billion (Ppb), Parts Per Billion	patients were assessed at baseline and 12 weeks	Fraction Exhaled Nitric oxide was measured on each visit prior to bronchoprovocation by chemiluminescence using an analyzer.
Forced Expiratory Volume in 1 Second (FEV1)	patients were assessed at baseline and 12 weeks	FEV1 in liters
Forced Expiratory Volume in One Second (FEV1) Percent Predicted	patients were assessed at baseline and 12 weeks	Spirometry was performed on each visit according to American Thoracic Society guidelines. FEV1 percent predicted was measured.